Journal of Pathology and Translational Medicine

Reviews

The Continuing Value of Ultrastructural Observation in Central Nervous System Neoplasms in Children: Na Rae Kim, Sung-Hye Park; J Pathol Transl Med. 2015;49(6):427-437. Published online October 13, 2015; DOI: https://doi.org/10.4132/jptm.2015.09.19

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Abstract PDF: Central nervous system (CNS) neoplasms are the second most common childhood malignancy after leukemia and the most common solid organ neoplasm in children. Diagnostic dilemmas with small specimens from CNS neoplasms are often the result of multifactorial etiologies such as frozen or fixation artifact, biopsy size, or lack of knowledge about rare or unfamiliar entities. Since the late 1950s, ultrastructural examination has been used in the diagnosis of CNS neoplasms, though it has largely been replaced by immunohistochemical and molecular cytogenetic studies. Nowadays, pathologic diagnosis of CNS neoplasms is achieved through intraoperative cytology, light microscopy, immunohistochemistry, and molecular cytogenetic results. However, the utility of electron microscopy (EM) in the final diagnosis of CNS neoplasms and investigation of its pathogenetic origin remains critical. Here, we reviewed the distinguishing ultrastructural features of pediatric CNS neoplasms and emphasize the continuing value of EM in the diagnosis of CNS neoplasms.

Utility of Transmission Electron Microscopy in Small Round Cell Tumors: Na Rae Kim, Seung Yeon Ha, Hyun Yee Cho; J Pathol Transl Med. 2015;49(2):93-101. Published online March 12, 2015; DOI: https://doi.org/10.4132/jptm.2015.01.30

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Small round cell tumors (SRCTs) are a heterogeneous group of neoplasms composed of small, primitive, and undifferentiated cells sharing similar histology under light microscopy. SRCTs include Ewing sarcoma/peripheral neuroectodermal tumor family tumors, neuroblastoma, desmoplastic SRCT, rhabdomyosarcoma, poorly differentiated round cell synovial sarcoma, mesenchymal chondrosarcoma, small cell osteosarcoma, small cell malignant peripheral nerve sheath tumor, and small cell schwannoma. Non-Hodgkin’s malignant lymphoma, myeloid sarcoma, malignant melanoma, and gastrointestinal stromal tumor may also present as SRCT. The current shift towards immunohistochemistry and cytogenetic molecular techniques for SRCT may be inappropriate because of antigenic overlapping or inconclusive molecular results due to the lack of differentiation of primitive cells and unavailable genetic service or limited moleculocytogenetic experience. Although usage has declined, electron microscopy (EM) remains very useful and shows salient features for the diagnosis of SRCTs. Although EM is not always required, it provides reliability and validity in the diagnosis of SRCT. Here, the ultrastructural characteristics of SRCTs are reviewed and we suggest that EM would be utilized as one of the reliable modalities for the diagnosis of undifferentiated and poorly differentiated SRCTs.

Citations

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Electron Microscopy in the Context of a Children's Research Hospital
Cam Robinson
Microscopy and Microanalysis.2020; 26(S2): 1610. CrossRef
Primary bilateral corneal nerve sheath neoplasm in a dog
Marina L. Leis, M. Elyse Salpeter, Bianca S. Bauer, Dale L. Godson, Bruce H. Grahn
Veterinary Ophthalmology.2017; 20(4): 365. CrossRef
Hirnbasissyndrom infolge eines Tumors bei einer 17 Monate alten Deutsch-Holstein-Färse
Wolf Wippermann, Sandra Schöniger, Kerstin Gerlach, Gerald Fritz Schusser, Gabor Köller, Alexander Starke
Tierärztliche Praxis Ausgabe G: Großtiere / Nutztiere.2016; 44(03): 180. CrossRef
The Continuing Value of Ultrastructural Observation in Central Nervous System Neoplasms in Children
Na Rae Kim, Sung-Hye Park
Journal of Pathology and Translational Medicine.2015; 49(6): 427. CrossRef

Case Reports

Multiple Jejunal Myeloid Sarcomas Presenting with Intestinal Obstruction in a Non-leukemic Patient: A Case Report with Ultrastructural Observations: Na Rae Kim, Woon Kee Lee, Jong In Lee, Hyun Yee Cho; Korean J Pathol. 2012;46(6):590-594. Published online December 26, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.6.590

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Abstract PDF

Myeloid sarcoma is a rare extramedullary myeloid tumor, which is frequently misdiagnosed when no evidence of leukemia is initially observed. Here, we report on a peculiar case of a 49-year-old man afflicted with multiple masses in the jejunum, the superior mesentery, and the serosa of the transverse colon, without leukemic manifestation. The tumor was composed of undifferentiated small round cells containing eosinophilic cytoplasm, which were negative for myeloperoxidase, nonspecific esterase, lysozyme, terminal deoxynucleotidyl transferase, leukocyte common antigen, CD3, CD4, CD15, CD20, CD30, CD43, CD56, CD68/PG-M1, CD79a, human melanoma black-45, c-kit, and CD34 with positivity only for CD68/KP1, CD99, and vimentin. Under electron microscopy, those cells had abundant membrane-bound cytoplasmic granules that measured 200 to 300 nm in diameter, which were consistent with granulocytic azurophilic granules. The tumor was finally diagnosed as a myeloid sarcoma. The presence of non-leukemic myeloid sarcomas showing immunonegativity for conventional myeloid-leukemic markers necessitated a diagnosis by ultrastructural observation.

Citations

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Primary ileal myeloid sarcoma presenting with bowel obstruction: a case report
Hitoshi Minagi, Nobuhiko Kanaya, Yoshitaka Kondo, Yoshihiko Kakiuchi, Shinji Kuroda, Ryohei Shoji, Hajime Kashima, Yuki Matsumi, Satoru Kikuchi, Kunitoshi Shigeyasu, Fuminori Teraishi, Shunsuke Kagawa, Toshiyoshi Fujiwara
Surgical Case Reports.2024;[Epub] CrossRef
Isolated myeloid sarcoma presenting with small bowel obstruction: a case report
Rie Mizumoto, Masanori Tsujie, Tomoko Wakasa, Kotaro Kitani, Hironobu Manabe, Shuichi Fukuda, Kaoru Okada, Shumpei Satoi, Hajime Ishikawa, Toshihiko Kawasaki, Hitoshi Hanamoto, Masao Yukawa, Masatoshi Inoue
Surgical Case Reports.2020;[Epub] CrossRef
Primary Myeloid Sarcoma of the Ileum and Mesentery Causing Small Bowel Obstruction: Case Report and Literature Review
Andrej Nikolovski, Dragoslav Mladenovikj, Aleksandra Veljanovska, Gordana Petrusevka
Lietuvos chirurgija.2020; 19(1-2): 55. CrossRef
Utility of Transmission Electron Microscopy in Small Round Cell Tumors
Na Rae Kim, Seung Yeon Ha, Hyun Yee Cho
Journal of Pathology and Translational Medicine.2015; 49(2): 93. CrossRef

Primary Hepatic Neuroblastoma: A Case Report.: Geunyoung Jung, Jihun Kim; Korean J Pathol. 2011;45(4):423-427.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.423

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Abstract PDF

Neuroblastoma is a malignant tumor of primordial neural crest origin. It usually develops along the sympathetic nervous system, such as the adrenal glands or paramedian sympathetic chain and metastasizes to the liver most frequently. However, a primary hepatic neuroblastoma has not been reported yet. Here, we report a case of 29-year-old woman who presented with a solitary hepatic mass. Grossly, the mass was large, creamy, rubbery firm, and showed focal hemorrhage and central cavitation. Microscopically, the tumor cells were arranged in small nests of spindle to ovoid cells with abundant neuropil. The neuroblastic nature of the tumor was confirmed by immunohistochemistry and electron microscopy. No extrahepatic mass was found, despite a thorough systemic survey such as chest and abdominopelvic computed tomography (CT) scans and a whole body positron emission tomography-CT study. To the best of our knowledge, this is the first report of a bona fide primary hepatic neuroblastoma.

Citations

Citations to this article as recorded by

Primary hepatic neuroblastoma in a 19-month-old child: A case report
Jovana Dimić, Dejan Skorić, Aleksandar Sretenović, Slaviša Đuričić
Medicinska istrazivanja.2022; 55(2): 41. CrossRef
Morphologic Alteration of Metastatic Neuroblastic Tumor in Bone Marrow after Chemotherapy
Go Eun Bae, Yeon-Lim Suh, Ki Woong Sung, Jung-Sun Kim
Korean Journal of Pathology.2013; 47(5): 433. CrossRef

Bronchoalveolar Lavage (BAL) Cytology and Ultrastructural Findings in a Patient with Amiodarone-Induced Pulmonary Toxicity: A Case Report.: Sun Lee, Min A Kim, Young Soo Shim, Chun Taek Lee, Je G Chi, Doo Hyun Chung; Korean J Pathol. 2002;36(3):175-178.

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Abstract PDF: Amiodarone is a potent antiarrhythmic agent and can cause potentially life-threatening pulmonary fibrosis. Of the numerous side effects associated with amiodarone therapy, lugn toxicity is one of the most serious adverse reactions. Recently, we experienced a case of amiodarone-induced pulmonary toxicity (APT), which induced severe dyspnea and productive coughing, confirmed by cytologic and electron microscopic examination of the bronchoalveolar lavage (BAL). The symptoms and abnormalities in the chest X-ray were improved after the withdrawal of amiodarone. Cytologic examination of the BAL revealed numerous foam cells with cytoplasmic vacuoles or small particles. Ultrastructurally, the foam cells demonstrated characteristic lysosomal inclusions, which were electron-dense multilamellated bodies, crystalloid bodies, and mixed forms with small lipid vacuoles. It is strongly suggested that only cytologic and electron microscopic examination of the BAL without open lung biopsy is enough for diagnosis of APT, when APT is clinically suspected in a patient who has a history or ingestation of amiodarone.

Carcinosarcoma (True Malignant Mixed Tumor) of the Parotid Gland: A Report of a Case with Small Cell Carcinoma as the Carcinoma Component.: Hun Soo Kim, Hyang Jung Cho, Yeun Tai Chung, Soon Ah Park, Hae Joong Cho, Jin Man Kim; Korean J Pathol. 2008;42(3):175-180.

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Abstract PDF: True malignant mixed tumor (carcinosarcoma) of the salivary gland is an extremely rare tumor. By definition, it is a heterologous neoplasm that's composed of both malignant epithelial and mesenchymal components. We report here on a case of an 83 year old female patient with a parotid gland mass. Histologic examination showed a biphasic pattern of growth with both a poorly differentiated epithelial component and a sarcomatous spindle cell background. The immunohistochemical and ultrastructural findings support the diagnosis of a small cell neuroendocrine epithelial tumor and an undifferentiated malignant mesenchymal features. The histologic and ultrastructural features along with the immunohistochemical findings are presented. We also review the literature and we discuss the different opinions on the exact histogenesis of the true malignant mixed tumor of the salivary gland. To the best of our knowledge, this histological pattern has not been previously reported in the English medical literature.

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